Obama Tepid on Public Option

Obama Tepid on Public Option

The sadness is that almost Obama’s entire speech could be read as a
splendid brief for universal single-payer health care, or at least
Medicare for all who want it.

But when Obama got down to specifics, he gave only tepid support to the public option.

He laid out clearly the problems with the current system, in
economic but also—and especially—moral terms, but then stepped back
from the fundamental changes that are necessary to meet that economic
and moral crisis.

The speech was by turns thoughtful and impassioned, conciliatory and
tough, dry and moving, ingenious and disingenuous, naïve and nobody’s
fool.

He appealed to reason and to our values—to the “character of our
country.” It was a term he borrowed from a letter he received from Ted
Kennedy, which was delivered posthumously. Obama used it and Kennedy’s
memory in an affecting way toward the end of the speech. He talked of
Kennedy’s “large heartedness,” and noted that because of this trait,
Kennedy saw a role for government to help the needy and those without
health care.

Obama also begged for civility even after one Republican shouted out
that he was a liar, and while Obama urged a bipartisan approach, he
finally showed some steel.

“Know this,” he told the Republican side. “I will not waste time
with those who have made the calculation that it's better politics to
kill this plan than improve it. I will not stand by while the special
interests use the same old tactics to keep things exactly the way they
are. If you misrepresent what's in the plan, we will call you out. And
I will not accept the status quo as a solution. Not this time. Not now.”

But he could have stiffened his spine several months earlier, and
for a bill that would have allowed anybody to join Medicare at any time.

That’s not this bill.

Hell, from the sounds of his speech, the public option is a goner.

When he finally got around to discussing the concept, he used the
word “can” instead of “must”: “An additional step we can take to keep
insurance companies honest is by making a not-for-profit public option
available in the insurance exchange.”

And after he went on defending the virtues of his diluted public
option (the only people who could join would be the uninsured), he then
tiptoed away from it.

“Its impact shouldn't be exaggerated – by the left, the right, or
the media,” he said. “It is only one part of my plan, and should not be
used as a handy excuse for the usual Washington ideological battles.”
He called it “only a means” to an end.

He then suggested he’d be open to co-ops instead, or a trigger later
on for a public option if the private insurers don’t behave themselves.

You could almost see the white flag in his suit coat pocket.

Actually, the only time he put his foot down on a specific detail of
the legislation was when he said: “I will not sign a plan that adds one
dime to our deficits, either now or in the future.” And then he
repeated the line in case we weren’t listening. He added that that the
bill would require more spending cuts if the savings he proposed don’t
materialize.

Chances are they won’t, since the Congressional Budget Office
already estimated that Obama’s plan would not be revenue neutral but
would cost hundreds of billions of dollars more.

The only way to really reduce health care costs across the board is
by single payer, since it would wipe out profits, advertising, and
immense systemic waste that occurs when doctors and hospitals have to
fill out forms for a myriad of different insurers.

And one of the best ways to reduce the costs in Medicare is to allow
the government to bargain for bulk drug discounts, but Obama already
gave that store away. (In his speech, he bragged about how the drug
companies are backing his bill, but he didn’t reveal why.)

So now Obama has embedded into the health care bill a recessionary
device—the automatic slashing of federal spending when health care
costs inevitably go up.

Obama also exaggerated the budgetary problem of health care when he said, “Our health care problem is our deficit problem.”

Actually, war is our deficit problem—$3 trillion for Iraq, and more for Afghanistan.

Actually, bailing out banks is our deficit problem—several trillion more, when you count the guarantees.

Obama himself waved at the cost of the Iraq War and the Bush tax cuts to the rich, which belied his earlier simplification.

And Obama misled the country when he said single-payer would require us to “build an entirely new system from scratch.”

No, it wouldn’t.

The system is in place.

It’s called Medicare.

And it works very well.

It’s a pity that a President with such intelligence and such
eloquence and, yes, “large heartedness” has not used his
attributes—along with his power and popularity—in service of the most
sensible and profound solution to the health care problem.

Instead, he’s left the private insurance companies and the drug companies running the show.

Further

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